The lower COVID-19 related mortality and incidence rates in Eastern European countries are associated with delayed start of community circulation

  1. Alban Ylli
  2. Yan Yan Wu
  3. Genc Burazeri
  4. Catherine Pirkle
  5. Tetine Sentell
1 evaluations Published on
Read the full article Related papers
This article on Sciety

Abstract

Background

The purpose of this analysis was to assess the variations in COVID-19 related mortality and incidence rates in relation to the time differences in the commencement of virus circulation and containment measures in different countries of the European Region.

Methods

The data for the current analysis (N=50 countries) were retrieved from the John Hopkins University dataset on the 7th of May 2020, with countries as study units. A piecewise regression analysis was conducted with mortality and cumulative incidence rates introduced as dependent variables and time interval (days from the 22nd of January to the date when 100 first cases were reported) as the main predictor. The country average life expectancy at birth was statistically adjusted for in the regression model.

Results

Mortality and incidence were strongly and inversely intercorrelated with days from January 22, respectively −0.83 (p<.0001) and −0.73 (p<.0001). Adjusting for average life expectancy, between days 33 to 50 from the 22th of the January, the average mortality rate decreased by 30.4/million per day (95% CI: 23.2, 37.1, p<0.0001). During interval 51 to 73 days, the change in mortality was no longer statistically significant but still showed a decreasing trend. A similar relationship with time interval was found in incidence. Life expectancy was not associated with mortality rate.

Conclusion

Countries in Europe which observed the earliest COVID-19 circulation, suffered the worst consequences in terms of health outcomes, specifically mortality. The drastic social isolation measures, undertaken especially in Eastern European countries, where community circulation started after March 11th, may have been timely. This may explain their significantly lower COVID-related mortality compared with the Western European countries.

Related articles

Related articles are currently not available for this article.